Individual
ELLICIA NOVELLA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
912 S DACOTAH ST, LOS ANGELES, CA 90023-1623
(310) 591-0326
Mailing address
912 S DACOTAH ST, LOS ANGELES, CA 90023-1623
(310) 591-0326
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
99760
CA
Other
Enumeration date
09/23/2025
Last updated
09/23/2025
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